Two out of every three deaths among young people in the poorest countries of Africa and Asia result from just a handful of illnesses. Each year worldwide, more than 11 million people die from these preventable or curable afflictions. Microbial resistance to treatment could bring the world back to a pre-antibiotic age. Currently, there are no new drugs or vaccines ready to emerge from research and development. For the major infectious killers, research and development funding continues to be inadequate. Because many physicians believed that infectious disease was a thing of the past, research into new drugs designed to combat bacterial infections was discontinued. Researchers soon discovered that pathogens develop resistance to antimicrobials through a process known as natural selection. When a microbial population is exposed to an antibiotic, more susceptible organisms will succumb, leaving behind only those resistant to the antimicrobial onslaught. Disease thrives in conditions of civil unrest, poverty, mass migration, and environmental degradation where large numbers of people are exposed to infectious diseases with little in the way of the most basic health care. The challenge is to slow the rate at which resistance develops and spreads. Poverty and inadequate access to drugs continue to be a major force in the development of resistance. Misdiagnosis is another symptom of weak public health systems, as well as counterfeit drugs, high-priced prescriptions, patient pressure, lack of education, inadequate hygiene practices among health care workers, antibiotics in the food supply, and globalization. The major diseases growing in resistance to antibiotics are pneumonia, diarrhoeal diseases, AIDS, tuberculosis, malaria, viral hepatitis, hospital-acquired infections, leishmaniasis, gonorrhoea, and common worms. Recommendations include educating health workers and the public on the use of medicines, containing resistance in the hospital, reducing the use of antimicrobials in animals, increasing research for new drugs and vaccines, increasing availability of essential drugs, and making effective medicines accessible to the poor.